Deciding which residency program is right for you

Choosing which residencies to apply to is one of the biggest decision of your career. Your residency plays a part in shaping your future as a physician. Just as you may have put a lot of thought into where to apply to medical school, you should give equal consideration to where you want to complete your residency training. There are several different factors you should take into consideration. It may be helpful to break things down into a few different categories.

Career Goals

One of the first things to take into consideration is your career goals. Do you want to be involved in research, academia or open a private practice? If you have a pretty good idea of what direction you want your career to take, it can help you decide, which residency programs to apply to. For example, if you want to pursue a career at a large teaching hospital, a residency in family practice in a rural area is not your best bet.

You may also want to consider the program’s reputation. Attending a highly ranked residency program may give you more opportunities for a prestigious fellowship. Keep in mind, you may not match with your first choice if it is a highly competitive program.

Program Location

You may think location is not a big concern. But where you will be spending the next few years may be something to think about. In some instances, you may go right into practice after residency or apply for a fellowship in your area.

There are different things to consider about your location. Depending on how long your residency program is, you may be spending three years or more at a certain location. Think about whether or not you are comfortable living in the area for the foreseeable future.

It is also important to consider the cost of living. The salaries for residents vary based on the program, specialty and location. But in most cases, residents will not make what attending physicians earn. Residency may also mean paying back students loans. For some doctors, their years of residency also is a time they may have added expenses, such as getting married or buying a house.

In addition to the cost of living, consider what the area has to offer. Are there a lot of recreational, cultural or outdoor opportunities? Think about what is most important to you in a city or town. Although the location may not be a deal breaker when choosing your residency, it is something to consider.

Program Specifics

One of the most important factors to think about is the program specifics or characteristics. For example, is there an appropriate balance between autonomy and supervision? Residency is still a time to train, but you also need to learn to trust your abilities and make your own decisions. A program that guides and supervises residents but also allows them some autonomy is beneficial.

Make sure the residency program is stable. Determine how long the program has been in existence. New programs may not have all the kinks worked out yet. During your interview, ask about any plans for the facility. Hospitals are sold, and mergers happen all the time. That is not necessarily a bad thing, but if you start a residency in a small hospital and it is sold a year down the line, will that impact residents?

Find out what the patient volume is like? Although it can be impossible to predict an exact patient volume, hospitals have a general idea of how many patients they treat each year. Also, consider the patient demographics in the area. For example, if you are planning a pediatric residency, but the area has a large population of older adults, you may not get the patient volume needed.

You also want to make sure the program offers support to their residents. Although this can be difficult to assess, consider how many residents transfer after their first year. Determine if a large number or residents stay at the facility for fellowships. Do current residents feel supported?

Learn as Much as you can During Your Interview

When you interview, do not be afraid to ask questions. Many people attend interviews with the idea they have to prove they are the right person for the residency. While this is true, an interview is also a time to determine if the program is right for you.

Although you do not want to seem as if you are conducting an interview, ask the questions you have. Look at your interviews as an opportunity to gather information on residency programs. This is your life and your future. You need to determine if a program is a good fit.

Before you attend your residency interviews, consider what is most important to you about a program. Some typical questions to consider asking include those listed below.

Are there informal learning opportunities for residents?

How is the orientation structured for incoming residents?

How much time do residents spend teaching med students?

What is the call schedule?

Do residents have opportunities to complete research?

Are there support services in place for residents who need academic help?

What does the benefits package for residents consist of?

Ranking Residency Options

After you complete a residency interview, it is crucial to organize your thoughts and decide how you are going to rank your residencies. If you asked similar questions during your interview, it should be fairly easy to compare programs.

Write down your impressions as soon as possible after you interview. Hopefully, you had the opportunity to talk with residents in the programs you applied to. Consider their input.

If possible, it is also a good idea to spend a day or two in the area where you would be doing your residency. Get a feel for what the area has to offer. Consider if it is somewhere you could see yourself living at least for the next few years.

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